United States veterans are a multifaceted population with a distinct culture that includes, but is not limited to, values, customs, ethos, selfless duty, codes of conduct, implicit patterns of communication, and obedience to command. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18–44 are most at risk. Health care professionals must be aware of patients' military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies, and utilizes veteran clinical faculty.
1 July 2019 in Journal of Nutrition and Metabolism
In the past, only people diagnosed with celiac disease, approximately 1% of the population, avoided gluten consumption through all their meals. However, popular media often now mistakenly present gluten-free foods as being a healthier choice, and more people have now concluded that gluten is a harmful part of the diet. A review of literature on gluten-free diets, gluten sensitivity, celiac disease, and attitudes toward gluten consumption was undertaken to examine the prevalence and consequences of adopting a gluten-free diet and to provide guidance to healthcare practitioners whose patients are now often adopting this diet without medical input. Aside from celiac disease, nonceliac gluten sensitivity (NCGS) occurs in those persons in which gluten ingestion leads to symptomatic manifestations in the absence of celiac disease or wheat allergy but who report a remission of certain symptoms after removing gluten from their diet. However, it was been shown that a large percentage of people who claim NCGS do not feel those manifestations under a double-blind challenge to gluten. Moreover, some parents, believing that ingesting gluten is detrimental for their health, adopt gluten-free diets for their children. A review of existing data shows that there are detrimental effects to going gluten free, including loss of the dietary fiber, deficiencies in dietary minerals and vitamins, and potential heavy metal exposure. Healthcare practitioners should query patients about their dietary choices, and in cases of questionable adoption of gluten-free diet, patients and parents are educated about the detriments of a gluten-free diet, and in cases where patients continue to insist on gluten-free foods, referrals to nutritional counseling are warranted in order to minimize potential harm.
1 April 2013 in Journal of Multidisciplinary Healthcare
Background: This descriptive correlational and comparative study explored health-care faculty (HCF) attitudes toward interprofessional education (IPE) and interprofessional health-care teams, HCF perceptions of subjective norms, the influence of subjective norms on HCF intent to engage in IPE, and HCF intent to engage in IPE. In addition, differences among seven disciplines of HCF were explored. Methods: Nursing, medicine, pharmacy, physical therapy, occupational therapy, physician assistants, and social work faculty were identified. Stratified random sampling was used to ensure that the population surveyed was representative of the target population. The total sample for this study included 439 HCF from the seven identified health-care professions in the US. Data collection included measures of attitudes toward IPE and attitudes toward interprofessional health-care teams. Subjective norms were measured using two 7-point rating scales. Intent to engage in IPE was measured using a 10-point rating scale. Results: There were no significant differences among HCF groups regarding attitudes toward IPE or interprofessional health-care teams. Administrative faculty reported greater intent to engage in IPE than teaching faculty. HCF who were currently in or had previously engaged in IPE reported greater intent to engage in or continue to engage, and had higher attitude and subjective norm scores than faculty without IPE experience. The combination of perceived pressure from school administrators and attitudes toward IPE was the best predictor of intent to engage in IPE. Conclusion: IPE has the potential to influence patient quality of care and lead to better working relationships between health-care providers. HCF are more likely to engage in IPE when they believe their school's administrators think they should engage in IPE and when they have positive attitudes toward IPE.
Background: This study explored the positive and negative factors that influence interprofessional education (IPE) implementation in health care education programs across the United States. Methods: The study sample consisted of 439 (response rate 8.4%) health care faculties from seven health care professions (nursing, medicine, pharmacy, physical therapy, occupational therapy, physician assistant, and social work) who were asked what the positive and negative factors are that influence their decisions to engage in IPE. Results: Three positive categories and two negative categories concerning factors that influence health care faculty (HCF) intent to engage in IPE emerged. The three major categories of positive factors emerged as patient care, which was mentioned by 196 subjects or 54% of the sample, student learning, which was mentioned by 157 subjects or 43% of the sample, and health care teams, which was mentioned by 88 subjects or 24% of the sample. The two major categories of negative factors emerged as scheduling and coordination, which was mentioned by 230 subjects or 63% of the sample, and discipline culture which was mentioned by 103 subjects or 28% of the sample. Conclusion: This study contributes to the body of knowledge concerning the factors that influence effective IPE implementation. Discussion is provided regarding the positive and negative categories that emerged and how they influence effective IPE delivery.
As universities strive to raise their academic rank through the quality and quantity of scholarship in order to maintain their competitive edge and funding sources, faculty face pressure to increase number of publications and externally funded research (or project proposals). There are many challenges that make it difficult for faculty to meet a university’s research demand, such as increased work load in academia, teaching large-size classes of students, and other strict university deadlines related to book ordering, scheduling classes, posting grades, etc. Faculty work group conflicts, faculty incivility, and dwindling grant/research funding add to faculty stress. In order to promote scholarship in academia, administrative support, collaborative work environments, mentoring, and appropriate appraisal systems are needed to enable faculty to be more productive and satisfied.
10 October 2019 in POJ Nursing Practice & Research
Objectives: The study objective was to promote hospitalized veterans’ comfort through an art intervention (AI). Kolcaba’s comfort theory guided the study. Sample and setting: Researchers recruited residents from a Community Living Center (CLC) at Miami Veterans Administration Healthcare System (MVAHS). Nurse researchers and recreational therapists collaborated to deliver the AI. Methods and variables: A quasi-experimental pre-post-test design tested the AI on veteran comfort, depression, and social connectedness. Results: Over six-months, staff identified 81 residents as appropriate to recruit for the study. Fifty-one males and 10 females (ages 26-95) agreed (75% response rate). Due to data collection challenges, residents’ cognition, time constraints, disabilities, and respondent burden, only 18 sets of usable pre-post data were available for analysis (ns results). Implications for nursing: The AI was “significant” to many other participants (n = 160) who were unable or unwilling to complete the research instruments. The most popular AI activity, the monoprint, has been “adopted” by recreational therapists and suggested to enhance communication with oncology patients. Kolcaba’s comfort theory will continue to be promoted during art activities on CLC I and II with extension of art activities to the bedside of CLC III Hospice residents. Keywords: Veterans, Art, Intervention, Comfort, Long Term Care